2580--
LOT NO.
CP�LtI FOR PLUMBING PERMIT
TTY OF CUPERTINO
JAN 31 1964 L,. Sanitary No.
Dat a' , 1965Z Permit No.
Y OF CUPERTINO Fee $Z�:
Application is hereby made to the City of Cupertino for a permit to install plumbing
pipes and fixtures listed on the reverse side hereof, and agrees to install said prices
and/or fixtures in accordance with the provisions of the Plumbing Code of the City of
Cupertino, and all other laws applicable thereto.
Use of Premises
Address t 6L
By CONTRACTOR, AGENT
State License Approved '
PLUMBING INSPECTOR
RECORD OF INVECTION
Undergrouough... nd R
Partial Rough..
Rough. Complete_
J
Main Drain
Final...